Provider Demographics
NPI:1366427833
Name:RODRIGUEZ-GINORIO, HENRY A (MD)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:A
Last Name:RODRIGUEZ-GINORIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8718
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00910-0718
Mailing Address - Country:US
Mailing Address - Phone:787-753-4505
Mailing Address - Fax:787-753-4553
Practice Address - Street 1:735 PONCE DE LEON AVE
Practice Address - Street 2:TORRE DE AUXILIO MUTUO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-5022
Practice Address - Country:US
Practice Address - Phone:787-753-4505
Practice Address - Fax:787-753-4553
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-07
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5815207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE08220Medicare UPIN
0097344Medicare ID - Type Unspecified